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ID: 220
Category: Autoimmune Disease
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createdon: 18 Mar 2023
updatedon: 06 Apr 2023

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Author: Khoa Tran
Published Mar 18, 2023
Updated Apr 06, 2023

Table of contents

Neutropenia

Etymology and Pronunciation

Neutropenia (new-troh-PEE-nee-uh)
neutros - Greek for "neutral" referencing "neutrophils"
penia - Greek for "deficiency or poverty"

History of Neutropenia

Neutropenia is the deficiency of neutrophils.

In 1879, a German physician named Paul Ehrlich discovered that certain types of white blood cells, including neutrophils, played a critical role in the body's immune response to bacterial infections. Ehrlich's work on white blood cells laid the foundation for the study of immunology, and his discoveries led to the development of new treatments for infectious diseases.

Paul Ehrlich used a staining technique called the "Ehrlich triacid stain" to detect and classify different types of white blood cells, including neutrophils. The staining technique involved using a combination of three acidic dyes that would bind to different components of the cell, allowing for the identification and visualization of specific types of white blood cells under a microscope. This staining technique was a significant advancement in the study of immunology and allowed Ehrlich to make important discoveries about the role of white blood cells in the immune system's response to infections. He published his findings in a paper titled "On the Granular Constituents of the Blood and their Relation to the Eosinophile Cells".

The term "neutropenia" was first used in the medical literature in the 1920s to describe a condition characterized by a low number of neutrophils in the blood. 

In the 1950s and 1960s, researchers discovered that certain medications, such as chemotherapy drugs used to treat cancer, could cause neutropenia as a side effect. They also identified inherited genetic disorders that could cause neutropenia, such as severe congenital neutropenia (SCN) and cyclic neutropenia.

In the 1980s, advances in technology allowed researchers to study the genetic basis of neutropenia more closely. They discovered that mutations in specific genes could cause neutropenia, leading to the identification of several genetic disorders that are associated with the condition.

Modern Understanding of Neutropenia

Neutropenia is a condition characterized by a low number of neutrophils, which are a type of white blood cell that plays a crucial role in fighting off infections. There are several different types of neutropenia, which can be classified based on their underlying causes or clinical features. 

Here are some of the most common types of neutropenia:

1. Congenital neutropenia: This is a rare type of neutropenia that is present from birth and is usually caused by genetic mutations that affect the production or function of neutrophils. Congenital neutropenia can be further classified based on the specific gene mutations involved, such as Kostmann syndrome, severe congenital neutropenia (SCN), or cyclic neutropenia.
2. Acquired neutropenia: This type of neutropenia develops later in life and is often caused by other underlying health conditions or medications. Acquired neutropenia can be further classified based on its underlying cause, such as autoimmune neutropenia, drug-induced neutropenia, or infectious neutropenia.
3. Idiopathic neutropenia: This type of neutropenia has no identifiable underlying cause and is often referred to as "idiopathic neutropenia" or "chronic benign neutropenia". Idiopathic neutropenia is usually asymptomatic and does not require treatment, but regular monitoring is recommended to ensure that the neutrophil count remains within a safe range.
4. Febrile neutropenia: This is a specific type of neutropenia that occurs in response to an infection and is characterized by a low neutrophil count (less than 500 cells/mm3) and fever. Febrile neutropenia is a medical emergency that requires prompt treatment with antibiotics and other supportive measures to prevent serious complications.
5. Chronic neutropenia: This is a type of neutropenia that persists for more than 6 months and is often asymptomatic or associated with mild symptoms such as recurrent infections or fatigue. Chronic neutropenia can be caused by a variety of underlying health conditions, such as autoimmune disorders or bone marrow disorders.
6. Transient neutropenia: This type of neutropenia is characterized by a temporary decrease in the neutrophil count, which can be caused by a variety of factors such as viral infections, medications, or stress. Transient neutropenia usually resolves on its own without treatment, but in some cases, supportive measures such as rest and hydration may be recommended.

One of the main symptoms of neutropenia is an increased susceptibility to infections, particularly bacterial infections. People with neutropenia may experience frequent or severe infections, such as pneumonia, skin infections, and urinary tract infections. They may also experience fever, chills, and other flu-like symptoms.

In some cases, neutropenia can also cause symptoms related to the underlying condition that is causing it. For example, a person with autoimmune neutropenia may experience symptoms such as joint pain, fatigue, and rashes, while a person with cyclic neutropenia may experience mouth sores, gum inflammation, and other oral health problems.

Neutropenia can be a serious condition, particularly for people who are already immunocompromised due to an underlying health condition or medical treatment. It is important to seek medical attention if you experience any symptoms of infection, particularly if you have a history of neutropenia or other immunodeficiency disorders. Your healthcare provider can perform a blood test to determine if you have neutropenia and help you develop a treatment plan to manage your condition and prevent infections.

Neutropenia is usually diagnosed through a complete blood count (CBC) test, which measures the levels of different blood cells, including neutrophils. A low neutrophil count is indicative of neutropenia.

Further confirmation tests may include a bone marrow aspiration or biopsy, which involves collecting a small sample of bone marrow to examine under a microscope. This can help determine the underlying cause of the neutropenia, such as a bone marrow disorder or leukemia.

Other tests may be ordered to rule out potential causes of neutropenia, such as infections or autoimmune disorders. These may include blood cultures, serology tests, or genetic testing.

Causes of Neutropenia

1. Inherited neutropenia: Some people can inherit neutropenia from their parents. This type of neutropenia is rare, and it is usually diagnosed during infancy.
2. Autoimmune disorders: Autoimmune disorders such as lupus and rheumatoid arthritis can cause neutropenia. In these cases, the body's immune system mistakenly attacks its own neutrophils.
3. Viral infections: Viruses such as HIV, hepatitis B and C, and Epstein-Barr virus can lead to neutropenia. These viruses can affect the bone marrow, where white blood cells are produced, leading to a decrease in neutrophils.
4. Medications: Certain medications, including chemotherapy drugs used to treat cancer, can cause neutropenia. Other drugs such as antibiotics, antifungals, and anticonvulsants can also lead to a decrease in neutrophils.
5. Radiation therapy: Radiation therapy used to treat cancer can damage the bone marrow and lead to neutropenia.
6. Nutritional deficiencies: Deficiencies in certain vitamins and minerals, such as vitamin B12, folate, and copper, can cause neutropenia.
7. Blood disorders: Blood disorders such as leukemia and myelodysplastic syndrome can cause neutropenia. These conditions affect the bone marrow's ability to produce normal white blood cells.
8. Other medical conditions: Certain medical conditions such as liver disease, kidney disease, and sepsis can lead to neutropenia.

Treatments for Neutropenia

Neutropenia is a medical condition characterized by an abnormally low level of neutrophils, a type of white blood cell that plays a crucial role in fighting off infections. Neutropenia can be caused by a variety of factors, including viral infections, chemotherapy, autoimmune diseases, and genetic disorders.

The treatment of neutropenia depends on its underlying cause. In some cases, neutropenia is a side effect of chemotherapy or radiation therapy, and the treatment may involve reducing the dose of the medication or temporarily stopping the treatment altogether. For patients with autoimmune diseases or genetic disorders, the treatment may involve managing the underlying condition with medication or other therapies.

For patients with severe neutropenia, the treatment may involve stimulating the production of white blood cells through the use of medications called colony-stimulating factors. These medications can help to increase the number of neutrophils in the bloodstream, reducing the risk of infections.

In addition to medical treatments, there are several lifestyle changes that can help to prevent or manage neutropenia. Patients with neutropenia should be diligent about hand hygiene and should avoid exposure to people who are sick or have infections. They should also avoid contact with potentially contaminated items, such as raw or undercooked meat, fish, or eggs.

Patients with neutropenia should also follow a healthy diet and get regular exercise to help boost their immune system. This may involve eating a diet rich in fruits, vegetables, whole grains, and lean proteins, and avoiding processed and sugary foods.

Finally, patients with neutropenia should be vigilant about any signs of infection and should seek medical attention if they experience fever, chills, sore throat, or other symptoms of infection. With proper treatment and management, most patients with neutropenia are able to live healthy and active lives.

Symptoms

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Mouth ulcers
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Skin infections
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Pneumonia
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Sinus infections
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Urinary tract infections
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860
Fever
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Sore throat

Confirmation Tests

- Blood test
- Bone marrow aspiration (biopsy)
- Genetic testing

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